Medicare Compliance & Reimbursement

Congressional proposals could mean more business for therapists.

Therapy providers who've been losing sleep over physician-owned specialty facilities siphoning off their patients can rest easy.

Congress is considering a permanent clamp down on physician self-referrals that could put money back in therapists' pockets.

The Senate Finance Committee and the House Ways and Means Committee held hearings March 8 to discuss physician referrals to specialty hospitals they own.
 
Finance Committee Chair Charles Grassley (R-IA) is considering legislation that will prohibit investing physicians from referring patients to their specialty hospitals, according to a March 11 American Physical Therapy Association bulletin. For now, Congress will extend the current moratorium on new physician-owned facilities until January 2007, as the Medicare Payment Advisory Commission recommends.

More money rather than enhanced quality of care may be driving these referrals, so providers, including therapists, should keep an eye on this issue.

"The message we're sending to the congressional committees is to take a close look at the incentives that are inherent in ownership arrangements," says Dave Mason, APTA's vice president for government affairs.

For physical therapists, physician referrals are a requirement for services, so the issue is particularly sensitive, observes Mason.